<div id="fullBg" class="fullBg none"></div>
<div action="createClaim" id="create_claim_dialog" class="dialog adddialog none" style="margin-top: -263px; margin-left: -325px;">
	<input type="hidden" name="abnormalId" />
	<input type="hidden" name="insuranceId" />
	<div class="dialogTitle">理赔</div>
	<button class="closeDiv">×</button>
	<div class="dialog_content" id="createClaimBody">
		<script type="text/template" id="createClaimTpl">
			{@each datas as it}
			<div class="dialogDataLine">
				<div>理赔单号：
					<input name="" disabled="disabled" type="text">
				</div>
				<div>异常单号：
					<input readonly="readonly" name="abnormalNumber" type="text">
				</div>
			</div>
			<div class="dialogDataLine">
				<div>保险公司：
					<input value="${it.insuranceCompany}" name="insuranceCompany" type="text">
				</div>
				<div>保险单号：
					<input name="" value="${it.insuranceNumber}" type="text">
				</div>
			</div>
			<div class="dialogDataLine">
				<div>索赔总金额：
					<input readonly="readonly" class="claimAmounts" type="text">
				</div>
				<div>理赔日期：
					<input isNULL="1" codeName="理赔日期" readonly="readonly" onclick="WdatePicker({});" name="claimDate" type="text">
				</div>
			</div>
			<div class="dialogDataLine">备注：
				<textarea isNULL="1" codeName="备注" name="claimRemark"></textarea>
			</div>
			<div class="dialogDataLineTitle">理赔明细：</div>
			<div class="dialogDataLineTable">
				<table>
				<tr>
					<th>&nbsp;&nbsp;&nbsp;&nbsp;险种</th>
					<th>保额</th>
					<th>保费</th>
					<th>索赔金额</th>
					<th>赔偿金额</th>
					<th>赔付日期</th>
				</tr>
				{@each it.insuranceCoverages as item}
				<tr>
					<td>&nbsp;&nbsp;&nbsp;&nbsp;<input type="hidden" value="${item.insuranceCoverageId}" name="insuranceCoverageId" />${item.coverageName}</td>
					<td>&#65509;${item.insuranceAmount}</td>
					<td>&#65509;${item.premium}</td>
					<td><input isNULL="1" value="0" codeName="索赔金额" class="claimAmount" name="claimAmount" type="text" onchange="value=value.replace(/[^\d{1,}\.\d{1,}|\d{1,}]/g,'')"/></td>
					<td>-</td>
					<td>-</td>
				</tr>
				{@/each}
			</table>
			</div>
			{@/each}
		</script>
	</div>
	<div class="footerBtn ad_button">
		<div class="dialogBtn dialogHandlerBtn sure_yes">确定</div>
		<div class="dialogBtn dialogHandlerBtn sure_no">取消</div>
	</div>
</div>